About Coeliac Disease

What is Coeliac Disease?

Coeliac Disease is a medical condition and is a permanent intolerance to dietary gluten. In people with coeliac disease the cells which line the small intestine (bowel) become damaged by the ingestion of gluten, a protein found in certain grains including wheat, barley, oats and rye. This process causes a flattening of the tiny, finger-like projections (called villi) which line the inside of the bowel, and is called villous atrophy.

The function of the small intestine is to break down and absorb the nutrients in food. In untreated coeliac disease, the cells lining the small intestine become flat and inflamed and their surface area is significantly reduced. This results in a reduction in the absorption of nutrients from food. This leads to deficiencies in vitamins, iron, folic acid and calcium, because of poor absorption. Sugars, proteins and fats are often poorly absorbed as well. Click here to visit a useful introductory site with further information.

"Coeliac Disease" - A public Lecture" 

Here is a great lucture which was held at Walter and Eliza Hall - it's worth watching but make sure find a comfy chair, grab yourself a cup of tea and gluten free buscuit and enjoy. 

https://www.youtube.com/watch?v=2a9_Ck8e90w
 

 

What causes Coeliac Disease?

People with coeliac disease are sensitive to gluten. At some point in their lives, the body’s immune system starts reacting to dietary gluten. This results in damage to the lining of the small intestine, resulting in poor absorption of nutrients from food. It is not yet known what causes this reaction, although genetics and environmental factors are thought to be involved. Gluten reacts with the small bowel lining, damaging it and causing loss of effective absorption surface area of the villi or finger like projections. It appears both genetic and environmental factors play important roles in coeliac disease.
 

Does Coeliac Disease run in families?

On average, about 10% of first degree relatives (parents, brothers, sisters or children) of a person with coeliac disease also have the disease. If one identical twin has coeliac disease there is a 70% chance that the other twin will develop coeliac disease as well. Research is suggesting that there appears to be some genetic factors involved in coeliac disease.

 

Symptoms

The signs and symptoms of coeliac disease are many and varied. These symptoms result from the presence of unabsorbed food and nutrients in the bowel, and from the effects on the body of poor absorption (malabsorption) of nutrients from the bowel into the body. Some people experience many symptoms, while others have few or no symptoms. Some of the signs and symptoms of coeliac disease are listed below:

  • Abdominal (tummy) bloating and/or cramping
  • Flatulence (wind)
  • Diarrhoea or loose, bulky bowel motions
  • Fatty stools (steatorrhoea)
  • Nausea
  • Weight loss or difficulty in gaining weight
  • Anaemia: most commonly due to iron deficiency and/or folic acid deficiency
  • Growth delay in children
  • Irritiability in children
  • Fatigue or lethargy
  • Mouth ulcers
  • Infertility and/or recurrent miscarriages
  • Reduced bone mineral density (osteoporosis)

 

Diagnosis of Coeliac Disease

Coeliac disease is diagnosed by taking a biopsy of the lining of the small intestine. This is done during a gastroscopy procedure, which involves passing a fibre optic instrument through the mouth, into the stomach and through into the small intestine. The doctor performing the procedure can view the oesophagus, stomach and small intestine as the instrument passes through them. In the small intestine a small piece of the tissue which lines the bowel is collected using forceps and viewed by a pathologist under a microscope. If the small intestine lining shows abnormalities characteristic of coeliac disease, then the diagnosis is confirmed. The biopsy test is essential for the proper diagnosis of coeliac disease, and referral to a specialist gastroenterologist is usually necessary.

Because many other conditions can produce similar symptoms to coeliac disease, the diagnosis should never be made on the basis of symptoms alone. There are also blood tests that measure antibodies to gluten which are available as a screening test for coeliac disease. These can be helpful in deciding whether someone is likely to have coeliac disease, but they should not replace the biopsy in confirming the presence of coeliac disease. If coeliac disease is suspected, a gluten free diet should not be started until a biopsy has been performed, as this will make it difficult to confirm the proper diagnosis.

 

Is there a cure for Coeliac Disease?

People with coeliac disease will always be sensitive to dietary gluten. At present there is no known cure for the condition. However, coeliac disease can be treated by removing gluten totally from the diet: by following a gluten free diet for life. In most people, this results in resolution of symptoms and a return to good health. Children with coeliac disease who follow a nutritionally adequate gluten free diet can expect normal growth and development.